ArticleSkeletal radiology2026
Multilevel evaluation of the median nerve in carpal tunnel syndrome using microvascular doppler ultrasonography.
Article in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare the diagnostic performance of microvascular ultrasonography-derived vascularity index (VI) and median nerve cross-sectional area (CSA) measured at multiple anatomical levels in relation to electroneuromyography (ENMG)-based severity of carpal tunnel syndrome (CTS). MATERIALS AND
methodsIn this prospective study, 101 hands from 67 patients with ENMG-confirmed CTS (mild, moderate, severe) were evaluated. CSA was measured at four anatomical levels, and VI was obtained at three levels using a standardized microvascular ultrasonography protocol. Group differences were analyzed with non-parametric tests. Receiver operating characteristic (ROC) analyses were performed to assess diagnostic performance.
resultsCSA differed significantly across severity groups only at the pre-carpal tunnel level (P = 0.009). VI showed significant overall differences at the pre-carpal, proximal tunnel, and distal tunnel levels (P < 0.001, P < 0.001, and P = 0.001, respectively). For distinguishing moderate-to-severe CTS from mild CTS, pre-carpal and proximal tunnel VI measurements showed comparable discriminatory performance, with an AUC of 0.75 at both levels. For identifying severe CTS, pre-carpal tunnel VI showed an AUC of 0.76.
conclusionVI derived from microvascular ultrasonography demonstrates a more consistent and discriminative association with CTS severity than CSA. These findings support its potential as a quantitative, non-invasive imaging biomarker for CTS severity stratification in clinical practice.
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